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Emergency physicians maintain performance on the American Board of Emergency Medicine Continuous Certification
Catherine A Marco1, Francis L Counselman, Robert C Korte
1The Department of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH; The American Board of Emergency Medicine, East Lansing, MI.
Insights
Emergency physicians maintain their medical knowledge throughout their careers, as demonstrated by consistent performance on the American Board of Emergency Medicine
Area of Science:
- Medical Education
- Emergency Medicine
- Physician Assessment
Background:
- The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program ensures ongoing competency through the Continuous Certification (ConCert) examination.
- The ConCert exam is a validated tool assessing emergency physicians' medical knowledge and clinical reasoning every 10 years.
Purpose of the Study:
- To analyze longitudinal physician performance on the ABEM ConCert examination over multiple testing cycles.
- To determine if emergency physicians maintain medical knowledge throughout their careers.
Main Methods:
- A longitudinal review compared ConCert examination performance of residency-trained emergency physicians across multiple cycles.
- Growth curve modeling was used to analyze performance trajectories, adjusting for initial physician ability.
- Data included 15,085 first-time testing episodes from 1989 to 2012.
Main Results:
- Mean adjusted ConCert scores remained stable across examination cycles (Cycle 1: 85.9, Cycle 2: 86.2, Cycle 3: 85.4).
- Growth curve analysis showed a slight increase in the second cycle (coefficient +0.3, p < 0.001) and a slight decrease in the third cycle (coefficient -0.5, p = 0.02).
- Initial qualifying examination scores significantly predicted ConCert performance.
Conclusions:
- Emergency physician performance on the ConCert examination is maintained over time.
- These findings indicate that emergency physicians retain essential medical knowledge throughout their professional careers.
Objectives:
The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program is a four-step process that includes the Continuous Certification (ConCert) examination. The ConCert examination is a validated, summative examination that assesses medical knowledge and clinical reasoning. ABEM began administering the ConCert examination in 1989. The ConCert examination must be passed at least every 10 years to maintain certification. This study was undertaken to determine longitudinal physician performance on the ConCert examination.
Methods:
In this longitudinal review, ConCert examination performance was compared among residency-trained emergency physicians (EPs) over multiple examination cycles. Longitudinal analysis was performed using a growth curve model for unbalanced data to determine the growth trajectories of EP performance over time to see if medical knowledge changed. Using initial certification qualifying examination scores, the longitudinal analysis corrected for intrinsic variances in physician ability.
Results:
There were 15,085 first-time testing episodes from 1989 to 2012 involving three examination cycles. The mean adjusted examination scores for all physicians taking the ConCert examination for a first cycle was 85.9 (95% confidence interval [CI] = 85.8 to 85.9), the second cycle mean score was 86.2 (95% CI = 86.0 to 86.3), and the third cycle was 85.4 (95% CI = 85.0 to 85.8). Using the first examination cycle as a reference score, the growth curve model analysis resulted in a coefficient of +0.3 for the second cycle (p < 0.001) and -0.5 for the third cycle (p = 0.02). Initial qualifying (written) examination scores were significant predictors for ConCert examination scores.
Conclusions:
Over time, EP performance on the ConCert examination was maintained. These results suggest that EPs maintain medical knowledge over the course of their careers as measured by a validated, summative medical knowledge assessment.